Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
Pediatr Dermatol. 2023 Jan;40(1):84-89. doi: 10.1111/pde.15170. Epub 2022 Nov 13.
BACKGROUND/OBJECTIVES: Pediatric lichen planus (LP) is rare with variable prevalence and atypical presentations compared to adults. Data on LP are lacking for the pediatric population in the United States. We present demographics, presentations, and treatments for a pediatric LP cohort.
We reviewed 26 patients diagnosed with LP at 20 years or younger. Treatment responses were defined as no response, partial response, and complete response.
Demographics included 54% females and median diagnosis age of 16 years (range 6-20). Most patients presented with cutaneous LP (65%), with fewer having associated oral (23%), nail (7.7%), or genital (3.8%) involvement. Some had cutaneous-only LP (38%) or strictly mucosal LP (oral-only 19% and genital-only 15%). LP lesions were pruritic (50%), painful (19%), and/or asymptomatic (35%). Complete/partial responses occurred with medium-potency topical corticosteroids in cutaneous (n = 7; 64%), oral (n = 3; 75%), and genital LP (n = 3; 100%), with high/ultra-high potency topical corticosteroids in oral LP (n = 6; 86%), and with topical calcineurin inhibitors in genital LP (n = 2; 100%). Side effects were clobetasol-related oral candidiasis and biopsy-related penile depressed scar. Most patients with available follow-up achieved remission (n = 17; 81%).
Pediatric LP usually presents in adolescence with cutaneous involvement and is symptomatic. However, patients frequently can have oral, genital, or nail lesions or may be asymptomatic, so they need thorough examinations and follow-up. Long-term remission is common due to treatment or natural disease course. Medium-potency corticosteroids are recommended for cutaneous, oral, and genital LP. Various other local and systemic therapies exist with successful treatment responses.
背景/目的：与成人相比，儿童型扁平苔藓（lichen planus，LP）较为罕见，且具有不同的流行率和不典型表现。美国针对儿童 LP 的数据较为缺乏。我们报告了一个儿科 LP 患者队列的人口统计学、表现和治疗情况。
我们回顾了 26 名在 20 岁或以下被诊断为 LP 的患者。治疗反应定义为无反应、部分反应和完全反应。
人口统计学特征包括 54%的女性和中位数诊断年龄为 16 岁（范围 6-20 岁）。大多数患者表现为皮肤 LP（65%），较少的患者存在口腔（23%）、指甲（7.7%）或生殖器（3.8%）受累。有些患者仅有皮肤 LP（38%）或仅为黏膜 LP（口腔 LP 仅 19%，生殖器 LP 仅 15%）。LP 病变有瘙痒（50%）、疼痛（19%）和/或无症状（35%）。中效外用皮质类固醇在皮肤 LP（n=7；64%）、口腔 LP（n=3；75%）和生殖器 LP（n=3；100%）中产生完全/部分反应，高/超高效外用皮质类固醇在口腔 LP（n=6；86%）中产生反应，外用钙调磷酸酶抑制剂在生殖器 LP（n=2；100%）中产生反应。副作用包括与氯倍他索相关的口腔念珠菌病和活检相关的阴茎凹陷性瘢痕。大多数有随访资料的患者达到缓解（n=17；81%）。
儿科 LP 通常在青春期出现，表现为皮肤受累且有症状。然而，患者常有口腔、生殖器或指甲病变，或可能无症状，因此需要进行全面检查和随访。由于治疗或自然病程，长期缓解较为常见。中效皮质类固醇推荐用于皮肤、口腔和生殖器 LP。存在多种其他局部和全身治疗方法，均有成功的治疗反应。
